Buttercup (Calcinosis cutis) - Buttercup is now in heaven

Thanks Marianne,

Still learning about this. I shot off a e-mail to the Vet and ? why this was even performed since we already know that she has PDH. The test was originally requested by the Vet at UC Davis and my Vet just followed the request from the Vet at Davis. I have now exhausted her ins. for this illness & must spend our money wisely and finding out that I just blew 233.00 for a test she did not need.

Just got of the phone with her vet & she explained the reason why Davis wanted that test performed. Apparently she had a stim test done on 1-6 and she was in the high end of normal, so this test was needed to meassure the signal that the pituitary it sending out to the adrenals & since the signal is 3 times were it should be we will be starting her on trilo after she has finished her AB. She will get 10mg in the am & 10mg at night. I will start her on them on Feb 8th which is a saturday so that I can monitor the first 48 hours. I will take her in for a stim test 10 days later.

Now that we are moving into phase 2 I'm once again in unfamilar territory. " The medication Phase"

Thanks Dawn & Butters

Dawn! You will do just fine with the meds. You can do this! Just keep gathering information, and be ready. Starting very low is good.

I am ordering that spray too. :)

Dawn, thanks so much for the explanation! I'm very sorry for worrying you unnecessarily. This is the first time I've seen the endogenous ACTH used in this way, so Butters is definitely providing an education for me, too!

Marianne

I've never seen the endogenous ACTH used in this way either, so I'm getting educated too!

Dawn, we will definitely help you with the "The medication Phase." ;)

Hugs, Lori

I don't understand the rationale for doing an endogenous acth test to validate a borderline acth stim test either. Everything I've read indicates that there can be an overlap in plasma acth concentrations between healthy and dogs with cushing's, which is why an endogenous acth test cannot be used to diagnose cushing's. I can only speculate that because the acth concentrations were so high, the vet felt there must be a definite disconnect between the pituitary and the adrenals, thereby lending more diagnostic credibility to a borderline acth stim test. Unfortunately, I can't find any credible, science based resources that would support that theory. I do know from past research, prompted by my bald pomeranian with high sex hormones, that the results of one study on Pomeranians with sex hormone derangements showed that some of these dogs with high 17OHP concentrations had higher concentration of plasma acth than healthy dogs. I don't recall the magnitude of elevation and I'm not sure it would be relevant anyway. That's just my two cents worth and without further evidence to the contrary, I remain uneducated on the subject of using the endogenous acth test for diagnosing HAC. :D

Ok, Lulusmom, you just hit me with a curve ball, what is HAC? Butters is a very different case as per Davis due to the size and overall location of the tumor, if the tumor was a half a cm bigger she would be dead by now. The radiation is shrinking the tumor and so far she has regained vision in her left eye, which she had lost due to pressure from the tumor, head aches I would have to say are gone, knuckling her paws over has been corrected, and since the radiation is still active , the tumor will continue to shrink. With everything that I have read about other pups being misdiag and dosing issues that so many have experienced that almost killed their babies, I want to make sure that all bases are covered, as per the multiple US that were performed to ck her adrenal glands and each showed that they were in good shape considering how hard they have been working . We are starting low 10 mg twice a day because of the borderline and just need to block enough of the ACTH message that the adrenal is receiving and sine the tumor is still shrinking, the message from the pituitary to the adrenal will continue to change at the same time, so it will be a real juggling act to keep track of the message being sent with out the test that she had. So as the tumor goes down so do the numbers and if we do not keep a.close.eye on that number while medicating her we could really screw her up and make her very sick, which would be devastating after all that she has been through. We are now 2 months post radiation(11/25,26,27) and as per the radiology dept the radiation will remain active for a other 4 months . Butters was very lucky to have been able to get the radiation treatment that saved her life and during the next several months her numbers will be constantly changing.

HAC is hyperadrenocorticism aka cushing's syndrome.

Duh, I've gotten so used to PDH and ADH that I forgot the H=HAC

Thanks Dawn

Butters had a nickle.size piece of CC pop of tonight and underneath it the skin is normal colored and healthy, Yeah way to go Butters, finally seeing positive changes in her skin condition.

Great news Dawn! Butters is on her way to recovery :)